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General NPI Number Information
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NPI Number | 1750764908
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Entity Type | Organization
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Legal Business Name | SHOSHANA STOCKELBERG, LCSW
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 50 HIGHWAY 9 S SUITE 101
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1574
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Country | US
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Telephone | 732-547-5082
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Fax | 732-431-4892
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Provider Business Mailing Address
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Address Line | 33 ENRIGHT AVE
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City | FREEHOLD
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State | NJ
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Zip | 07728-2029
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Country | US
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Telephone | 732-547-5082
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Fax | 732-431-4892
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHOSHANA STOCKELBERG
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Credential | LCSW
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Telephone | 732-547-5082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SC05276600
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License Number State | NJ
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